Repeal of the Affordable Care Act will be devastating for persons with mental illnesses in Illinois

On May 4, 2017, the United States House of Representatives voted 217 to 213 to repeal substantial portions of the Affordable Care Act (ACA). Notably, every single Democrat in the House, including every single Democratic from Illinois voted “NO.” Unfortunately, while 20 Republicans from other states also voted “NO,” the entire Republican Congressional contingent from Illinois vote “YES.”

This so-called “Repeal and Replace” bill will cause serious harm to persons with mental illnesses in Illinois. It will also harm many other people and will seriously worsen the state’s already precarious fiscal condition.

Here are some of the problems:

There will be $800 Billion in cuts to Medicaid. This is bad news for mental health services because Medicaid is the largest funding source for mental health treatment in the state Under the House bill, states must chose whether to take Medicaid funds as a block grant or per capita funding. Either way there will be less money and funding for mental health services will have to compete with other vital health needs for substantially reduced funding. Additionally, the Medicaid expansion funding which covers people up to 138% of the poverty level is being phased out. If someone in this program leaves Medicaid for any reason, they will never be able to return. In the end, several hundred thousand persons in Illinois will lose Medicaid coverage under the House bill.

Of course, Illinois could chose to increase its Medicaid funding to make up for these dramatic cuts. However, given the state’s precarious fiscal situation, this prospect seems unlikely.

It is important to remember that, while the Medicaid program provides life-saving health care to several million Illinois citizens, the Medicaid money does not in fact go to poor people. The money is paid to health care providers, including physicians, hospitals and many others. Medicaid funding supports thousands of jobs for Illinois citizens who contribute to the financial well being of the state and to its tax revenues. Illinois will lose hundreds of millions of dollars of economic activity if the ACA is repealed.

The ACA requires all health insurance policies to cover “essential health benefits.” Among those benefits is mental health care. The Republican repeal eliminates this requirement. So health insurance may be sold which does not provide ANY coverage for mental health treatment.

The Republican repeal also ends the requirement that pre-existing conditions be covered without substantial additional costs. Health insurance companies will now be free to charge substantially more for pre-existing conditions.